The present invention relates to a measurement tool or treatment tool for an endoscope.
A measurement tool for an endoscope is typically used for measuring a size of an ulcer or the like on a mucous membrane in a human cavity. The measurement tool is generally configured such that graduations are formed at a tip end portion of a flexible shaft, which is detachable inserted through an instrument tool insertion channel of the endoscope. An example of such a measurement tool is disclosed in Japanese Utility Model Publication HEI 6-44401.
With the measurement tool configured as described above, a size only in one direction can be measured, and a length in another direction cannot be measured. In order to measure the size of an object in two different direction, a direction where the graduations are provided should be changed. However, at the tip of the endoscope, at which a positional relationship with respect to the ulcer is limited, it is difficult to change the orientation of the distal end of the endoscope. Thus, it is almost impossible to directly measure the length of the object (e.g., ulcer) in two different directions. Therefore, a length in one direction should be guessed based on the measured length.
The Japanese Utility Model Publication HEI 6-44401 teaches a measurement tool provided with a flexible tube having two slits, which traverse the flexible tube in the diameter direction, at a certain interval along the axis of the flexible tube. By operation an operation wire, the distal end portion of the flexible tube, on which gradations are formed, is bent to form a T-shape. However, in such a configuration, the flexible tube is bent by 180 degrees at one of the two slits. Therefore, when such a bending operation is repeated, the flexible tube may be broken, at the slit, within a relatively short period of time.
Another typical tool for an endoscope is an injection tube for injecting contrast medium. A conventional injection tube is typically formed as a single tube made of flexible resin such as tetrafluoroethylene. An injection mouth is provided at the proximal end of the injection tube. At the distal end thereof, an end tip may be secured. In some injection tubes, a core metal is inserted so that the tube is not folded.
The tubular tool as described above is inserted in a treatment tool channel of an endoscope. In the conventional treatment tool, an orientation or a direction of a distal end portion of the tubular tool, which is protruded from the distal end of the endoscope, cannot be controlled. Therefore, according to the conventional art, the distal end portion of the flexible tube is formed to have tendency to bend in a predetermined direction. Even with such a tubular tool, it is still difficult to insert the tubular tool in a diverging tube at a deep portion of a bile duct or bronchial tubes.
Another typical treatment tool for an endoscope is a bendable treatment tool used for collecting tissues from a mucous membrane inside a human cavity.
As such treatment tools for collecting human tissues, ones having a brush tool or spoon tool are secured onto e tip end of a flexibly bendable sheath. An example of such a tool is described in Japanese Patent Provisional Publication HEI 05-142.
Conventional tools for collecting human tissues, as described in the above-described publication, are configured as precision instrument such that link members rotatable at respective rotation axes, which are perpendicular to the axis of the flexible tube, are provided at the tip end portion of the flexible sheath. The link members are configured to be bent/expanded upon back/forth movement of an operation wire.
With this precise structure, it is difficult to clean the tool completely after operation thereof. Further, due to the precise structure, the tool easily malfunctions. Due to the precise structure, such tools are relatively expensive and may not be disposable. Accordingly, the conventional tools may be reused in unstable condition.
Another typical treatment tool for an endoscope is a catheter, which is inserted in the forceps channel of an endoscope, and is used for feeding of chemicals or suction of bodily fluids.
The catheter for an endoscope is generally formed of a flexible tube having a simple structure. In order to lead the distal end of the catheter to a target position, it is preferable that the direction of the distal end portion is remotely changeable.
FIG. 35 shows a structure of a conventional catheter for an endoscope. As shown in FIG. 35, the conventional catheter includes a flexible tube 501. Inside the flexible tube 501, an operation wire 502 is loosely inserted. At the distal end portion of the flexible tube 1, a pair of holes 503 are formed, which are spaced along the axial direction by a predetermined amount. Between the holes 503, the operation wire 502 is located outside the flexible tube 501 and extends along the axis of the flexible tube 501. Further, the flexible tube 1 is provided with a plurality of circumferential grooves 504 at a predetermined interval so that the flexible tube 1 is easily bent.
In the catheter configured as described above, if the operation wire 502 has tendency to bend in a certain direction, the flexible tube 1 may meander. In such a case, the catheter cannot be used. Therefore, generally twisted wires having less rigidity are used as the operation wire 502.
When the operation wire 2 is pulled, the distal end portion of the flexible tube 501 is bent as indicated by two-dotted lines in FIG. 35. However, even if the operation wire is pushed, due to its low rigidity, the distal end portion of the flexible tube 1 may not bend. Thus, according to the conventional structure, it is very difficult to lead the distal end of the catheter to a desired direction.
A cytodiagnosis brush is known as treatment tool for an endoscope. Generally, the cytodiagnosis brush is configured such that a brush shaft provided with radially planted brush at the distal end portion thereof is connected with the distal end of a closely wounded coil pipe, which can be inserted in the treatment tool insertion channel of the endoscope.
Endoscopes should be cleaned and disinfected completely after they are used. However, for the cytodiagnosis brush described above, it is difficult to completely clean and disinfect inside the coil pipe. Therefore, in order to avoid contagion between patients via the cytodiagnosis brush, it must be disposed when it is used once, which has been considered wasteful.
Another typical treatment tool for an endoscope is a biopsy forceps for collecting biopsy tissues from the human cavity.
The biopsy forceps is generally configured such that an operation wire is movably inserted in a flexible sheath, and by moving the operation wire, a pair of forceps cups provided at the distal end of the flexible sheath are opened/closed.
In a conventional biopsy forceps configured as above, the direction of the distal end portion of the sheath cannot be changed. FIG. 46 schematically shows a branched portion of a brachial tube, in which an endoscope 750 is inserted. In FIG. 46, 701 denotes a flexible sheath and 702 denotes forceps cups. In this example, the endoscope should be inserted to a branched tube having a tumor 100. However, since the direction of the distal end portion of the flexible sheath 701 cannot be changed, when the flexible sheath 701 is protruded from the distal end of the endoscope, the flexible sheath enters the other tube as shown in FIG. 47.
Even if the flexible sheath 701 can be introduced in the desired tube, as shown in FIG. 48, the tissues are collected with the forceps cups 702 abutting against the tumor 100 from the side. Therefore, invasion area of malignant lesion may not be diagnosed accurately.
In Japanese Utility Model Publication SHO 52-33146 or Japanese Patent Publication SHO 53-10396, a biopsy forceps having a mechanism to bend the flexible sheath at the distal end portion thereof is described. However, if the sheath is very thin, such a mechanism cannot be practically employed in view of the strength and operability.
A further typical treatment tool for an endoscope is a high-frequency cutting tool used for cutting human tissues using a high-frequency.
FIG. 52 shows a structure of a conventional high-frequency cutting tool for an endoscope. As shown in FIG. 52, the conventional high-frequency cutting tool includes a flexible tube 801 made of electrically insulating material. Inside the flexible tube 801, a conductive wire 802 is loosely inserted. At the distal end portion of the flexible tube 801, a pair of holes 803 are formed, which are spaced along the axial direction by a predetermined amount. Between the holes 803, the conductive wire 802 is located outside the flexible tube 801 and extends along the axis of the flexible tube 801. Further, the flexible tube 801 is provided with a plurality of circumferential grooves 804 at a predetermined interval so that the flexible tube 1 is easily bent. Such a structure is disclosed in Japanese Patent Publication SHO 64-4335.
By pulling the conductive wire as indicated by arrow in FIG. 52, the distal end portion of the flexible tube 1 between the pair of holes 803 is bent as indicated by two-dotted lines in FIG. 52.
FIG. 51 shows a usage of the high-frequency cutting tool described above. The distal end portion of the flexible tube 1 is inserted in an opening of bile duct 102 communicating with the duodenum 101, and the high-frequency current is applied to the conductive wire 802. Then, the tissues at the opening are cut. In FIG. 51, 850 denotes the endoscope and 851 denotes the treatment tool channel of the endoscope 850.
In the conventional high-frequency cutting tool as described above, the bending amount of the distal end portion of the flexible tube 801 is determined only by the pulling force of the conductive wire 802, and in accordance with the bending amount, the cutting depth 800A of the tissues is determined.
However, the bending amount cannot be controlled accurately, and therefore, the cutting depth 800A may not be different from the intended amount.
According to some embodiments of the invention, there is provided a measurement tool for an endoscope, with which a two-dimensional size of an object such as an ulcer can be measured relatively easily and accurately.
According to some embodiments of the invention, there is provided a tubular treatment tool for an endoscope, which is configured such that the orientation of the distal end portion thereof can be changed arbitrarily with operation of an operation unit, and can be inserted in the diverging tube located deep inside the bile duct or bronchial tubes.
According to some embodiments of the invention, there is provided a bendable treatment tool for an endoscope, which has a relatively simple structure. Because of the simple structure, the tool may be cleaned easily, and is hard to malfunction. Further, due to its simple structure, the tool may be manufactured at a relatively low cost, and thus can be provided as a disposable tool.
According to some embodiments of the invention, there is provided a measurement tool for an endoscope, which has a relatively high durability, and can be manufactured at a relatively low manufacturing cost.
According to one embodiment of the invention, there is provided a catheter for an endoscope operable with an operation wire. The distal end portion of the catheter may be bent not only by pulling the operation wire but also pushing the operation wire so that the distal end portion of the flexible tube can be directed in a desired direction.
According to some embodiments of the invention, there is provided a cytodiagnosis brush which can be cleaned and disinfected completely after usage, and can be used repeatedly without contagion among patients.
According to some embodiments of the invention, there is provided a biopsy forceps, a direction of the distal end portion of which can be changed without employing a complicated mechanism and/or operation.
According to one embodiment of the invention, there is provided a high-frequency cutting tool with which the bending amount of the distal end portion of the flexible tube is controlled accurately so that the cutting amount can be adjusted to the desired amount.
In view of the above, according to the invention, there is provided a measurement tool for an endoscope, which is provided with a flexible shaft to be inserted in a treatment tool insertion channel of the endoscope, and an elastic sheet member secured to a distal end portion of the flexible shaft.
Optionally, the distal end portion of the flexible shaft may be bendable at a position on the proximal end side with respect to the elastic sheet member, the distal end portion of the flexible shaft being bendable in response to an operation at a proximal end of the flexible shaft.
Further optionally, the sheet member may include a substantially circular sheet.
In this case, the sheet member may include a plurality of sheets having different diameters, the plurality of sheets being secured to the flexible shaft at different positions.
The graduations may be formed on the sheet member.
In a particular case, the sheet member may be detachable secured to the flexible shaft.
The measurement tool may further include an elastic annular sheet secured to the flexible shaft, the annular sheet surrounding the sheet member.
According to another aspect, there is provided a tubular treatment tool for an endoscope, which includes a flexible tubular member, a groove traversing the flexible tubular member in a direction of a diameter thereof being formed, and an operation wire inserted in the flexible tubular member, the operation wire being movable relative to the flexible tube along an axis of the flexible tube, a distal end of the operation wire being secured to the flexible tube at a position on a distal end side with respect to the groove.
Optionally, the groove may have a V-shaped cross section.
Further, a tissue collecting device may be secured at the distal end of the flexible tube.
According to a further aspect of the invention, there is provided a tubular treatment tool for an endoscope, which includes a flexible tubular member, at least one pair of grooves each traversing the flexible tubular member in a direction of a diameter thereof being formed, and an operation wire inserted in the flexible tubular member, the operation wire being movable relative to the flexible tube along an axis of the flexible tube, the operation wire running outside of the tubular member through one of the pair of grooves and running inside of the tubular member so that the operation wire is located outside of the flexible tubular member between the pair of grooves, a distal end of the operation wire being secured to the flexible tube at a position on a distal end side with respect to the pair of grooves.
Optionally, each of the grooves may have a V-shape cross section.
Further optionally, at least one pair of grooves may include a plurality of pairs of grooves, the operation wire being located outside of the flexible tubular member between two grooves of each pair of the plurality of pair of grooves.
In this case, the plurality of pairs of grooves may be located at different positions along the circumference of the flexible tubular member.
Still optionally, a tissue collecting device may be secured at the distal end of the flexible tube.
According to another aspect of the invention, there is provided a measurement tool for an endoscope, which is provided with a flexible tubular member, a groove traversing the flexible tubular member in a direction of a diameter thereof being formed, at least a distal end side, with respect to the groove, of the flexible tubular member being formed with graduations, and an operation wire inserted in the flexible tubular member, the operation wire being movable relative to the flexible tube along an axis of the flexible tube, a distal end of the operation wire being secured to the flexible tubular member at a position on a distal end side with respect to the groove.
Optionally, the groove may have a V-shaped cross section.
Still optionally, a fluid injection mouth, which communicates with the flexible tubular member, may be provided at a proximal end portion of the flexible tubular member.
According to a further aspect of the invention, there is provided a catheter for an endoscope, which is provided with a flexible tubular member through which fluid passes, a groove traversing the flexible tubular member in a direction of a diameter thereof being formed, the groove having a V-shaped cross section, and an operation wire inserted in the flexible tubular member, the operation wire being movable relative to the flexible tube along an axis of the flexible tube, a distal end of the operation wire being secured to the flexible tubular member at a position on a distal end side with respect to the groove, a pair of holes being formed on both sides, along an axis of the flexible tubular member, of the groove, the operation wire being inserted through the pair of holes so that the operation wire being located outside of the flexible tubular member at a position between the pair of holes.
According to a further aspect of the invention, there is provided a cytodiagnosis brush for an endoscope, which is provided with a flexible tubular member, a brush shaft, a brush being radially planted at a distal end portion of the brush shaft, and a stopper secured to the proximal end of the brush shaft, the stopper being fixed to the flexible tubular member at a distal end portion thereof, a fluid passage along an axis of the flexible tubular member being defined in the stopper.
Optionally, a groove traversing the flexible tubular member in a direction of a diameter thereof may be formed, the groove having a V-shaped cross section, and the cytodiagnosis brush further comprises an operation wire inserted in the flexible tubular member, the operation wire being movable relative to the flexible tube along an axis of the flexible tube, a distal end of the operation wire being secured to the flexible tubular member at a position on a distal end side with respect to the groove, a pair of holes being formed on both sides, along an axis of the flexible tubular member, of the groove, the operation wire being inserted through the pair of holes so that the operation wire is located outside of the flexible tubular member at a position between the pair of holes.
According to another aspect of the invention, there is provided a biopsy forceps for an endoscope, which is provided with a flexible tubular member, an operation wire inserted through the flexible tubular member, a pair of forceps cups secured to the distal end of the flexible tubular member, a link mechanism with which the pair of forceps cups open and close upon operation of the operation wire, an incision being formed, from an outer surface of the flexible tubular member, at a distal end portion of the flexible tubular member along a direction of a diameter of the flexible tubular member.
Optionally, an end of the incision may be located substantially at a position past the inner diameter of the flexible tubular member.
In a particular case, the incision is a slit. Alternatively, the incision may be a groove having a V-shaped cross section.
According to a further aspect of the invention, there is provided a high-frequency cutting tool for an endoscope, which is provided with an electrically insulating flexible tubular member, at least one pair of grooves each traversing the flexible tubular member in a direction of a diameter thereof being formed, and a conductive wire inserted in the flexible tubular member, the conductive wire being movable relative to the flexible tube along an axis of the flexible tube, wherein a groove traversing the flexible tubular member in a direction of a diameter thereof is formed, the groove having a V-shaped cross section, a distal end of the conductive wire being secured to the flexible tubular member at a position on a distal end side with respect to the groove, a pair of holes being formed on both sides, along an axis of the flexible tubular member, of the groove, the conductive wire being inserted through the pair of holes so that the operation wire is located outside of the flexible tubular member at a position between the pair of holes.